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. 2019:41:e2019050.
doi: 10.4178/epih.e2019050. Epub 2019 Dec 18.

The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)

Mili Dutta  1 , Y Selvamani  2 , Pushpendra Singh  3 , Lokender Prashad  4
Affiliations

The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)

Mili Dutta et al. Epidemiol Health. 2019.

Abstract

Objectives: India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.

Methods: Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.

Results: The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.

Conclusions: In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.

Keywords: India; Nutritional status; Obesity; Overweight; Socioeconomic factors; Thinness.

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Conflict of interest statement

The authors have no conflicts of interest to declare for this study.

Figures

Figure 1.
Figure 1.
Flow chart for the sampling and sample selection, NFHS-4, 2015/16, India. NFHS, National Family Health Survey; PSUs, primary sampling units; CEB, census enumeration block; PPS, probability proportional to size.
Figure 2.
Figure 2.
Distribution of underweight and overweight/obesity among men and women in India, National Family Health Survey (NFHS)- 2005/06-2015/16.
Figure 3.
Figure 3.
Distribution of underweight and overweight/obesity among men (A, B) and women (C, D) across the states of India, National Family Health Survey-4, 2015/16, India.
See this image and copyright information in PMC

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